Two Cases of Juvenile Temporal Arteritis with Eosinophilia and Eosinophilic Vasculitis on Their Legs

Abstract

Case 1 was a 40-year-old man who developed prurigo-like papules on his extremities in February of 1988. Two years later, he noted that the skin above the bilateral temporal arteries was swollen and reddish without clinical signs. He continues to have peripheral eosinophilia (30~54%), high titer of IgE (20,529g/l), and thrombocytopenia (6.7×10⁹/l). Case 2 was a 51-year-old man who noted prurigo-like papules on his legs in 1999. After a year, he also developed a large indurated erythema on his left thigh and the swollen and reddish skin above the bilateral temporal arteries without clinical signs. He has peripheral eosinophilia (19~54%) and a high titer of IgE (5,405~11,510g/l). The skin biopsies of Cases 1 and 2 both showed eosinophilic vasculitis within the deep dermis and subcutaneous tissue. The biopsies taken from the temporal region in both cases showed that the lumen was obstructed and the internal elastic lamina was broken by infiltrated eosinophils and neutrophils. In these cases, the clinical, serological, and pathological findings were unusual, because temporal arteritis usually has severe symptoms without skin lesions, hypereosinophilia, or a high titer of IgE. Therefore, we suggest that these cases be diagnosed as juvenile temporal arteritis with eosinophilia as proposed by Fujimoto M. et al.